Table 1
Themes present in the first six months of narrative data associated with lower overall entrustment at the end of an internal medicine residency
|
Six themes |
Representative quotes |
|---|---|
|
Explicit/manifest: Resident performance | |
|
1. Gaps in attention to detail |
“There have been a few overlooks in regards to medications and orders that I have had to correct. I encouraged them to look at order and medication list on a daily basis as part of rounds to make sure that there is nothing important that is missing or needs to be removed” |
|
2. Communication deficits with patients |
“Bedside presentations include words that are not understandable to the patient” |
|
3. Difficulty recognizing the “big picture” in patient care |
“They could get a better handle of the overall picture of a patient instead of focusing only on the individual problems” |
|
Implicit/latent: Assessor description | |
|
4. Describing feedback as a deficiency rather than an opportunity to improve |
“Their knowledge base overall is not good enough to answer simple questions such as how different insulins work etc.” |
|
5. Normative comparisons that identified a resident behind their peers |
“Knowledge base is below what would be expected for an early intern” |
|
6. Warning of possible risk to patient care |
“Supervising resident and attending need to keep close eye on them, look at everything” |